Immunization coverage in Ethiopia among 12-23 month old children: systematic review and meta-analysis

BACKGROUND: Immunization is a cost-effective public health strategy. Immunization averts nearly three million deaths annually but immunization coverage is low in some countries and some regions within countries. The aim of this systematic review and meta-analysis is to assess pooled immunization coverage in Ethiopia. METHOD: A systematic search was done from PubMed, Google Scholar, EMBASE, HINARI, and SCOPUS, WHO's Institutional Repository for Information Sharing (IRIS), African Journals Online databases, grey literature and reviewing reference lists of already identified articles. A checklist from the Joanna Briggs Institute was used for appraisal. The I2 was used to assess heterogeneity among studies. Funnel plot were used to assess publication bias. A random effect model was used to estimate the pooled prevalence of immunization among 12-23 month old children using STATA 13 software. RESULT: Twenty eight articles were included in the meta-analysis with a total sample size of 20,048 children (12-23 months old). The pooled prevalence of immunization among 12-23 month old children in Ethiopia was found to be 47% (95%, CI: 46.0, 47.0). A subgroup analysis by region indicated the lowest proportion of immunized children in the Afar region, 21% (95%, CI: 18.0, 24.0) and the highest in the Amhara region, 89% (95%, CI: 85.0, 92.0). CONCLUSION: Nearly 50% of 12-23 month old children in Ethiopia were fully vaccinated according to this systematic review and meta-analysis this indicates that the coverage, is still low with a clear disparity among regions. Our finding suggests the need for mobile and outreach immunization services for hard to reach areas, especially pastoral and semi-pastoral regions. In addition, more research may be needed to get more representative data for all regions. Prospero registration number: crd42020166787.